Pain management for RA can take many forms. Medication, surgery, and physical therapy can help you live with less discomfort.

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It's not surprising that rheumatoid arthritis can cause a lot of pain. If you have this condition, your immune system goes haywire and causes your joints to become swollen, damaged, and even misshapen in some cases.

Fortunately, there are many powerful medications to help manage rheumatoid arthritis pain. In some cases, surgery can also help relieve your pain. And a physical therapist can provide even more strategies that can minimize joint swelling and discomfort.

Medications for Rheumatoid Arthritis Pain Management

Your doctor can suggest different types of drugs or combinations of drugs for your particular needs. These include:

Anti-inflammatory drugs. These medications help alleviate joint swelling, thereby reducing joint pain. "The most important thing is to find something that controls the inflammation. If you just try to treat pain and you don't reduce the inflammation, you commonly don't have very much success," says Richard Brasington, MD, a board-certified rheumatologist and a professor of medicine in the Division of Rheumatology at the Washington University School of Medicine in St. Louis.

You may have heard of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and the prescription strength medication celecoxib (Celebrex). NSAIDs are "probably the mainstay of pain relief in rheumatoid arthritis," Dr. Brasington says.

NSAIDs can irritate your digestive system, however. Some can also raise your risk of heart attack or stroke.

Corticosteroids. These drugs — which include prednisone — can be useful in treating rheumatoid arthritis flare-ups, says Larry Moreland, MD, chief of the division of rheumatology and clinical immunology at the University of Pittsburgh.

These drugs are best used for short-term relief. Using them too long can raise your risk of problems such as infection, bleeding of the stomach lining, and osteoporosis.

Disease-modifying drugs. Disease-modifying antirheumatic drugs (DMARDs) — such as methotrexate, hydroxychloroquine, and azathioprine — are often used to disrupt the progress of the underlying disease, but can also provide some pain relief.

DMARDS can take weeks or months to reduce symptoms, but they reduce joint damage over the long term. Your doctor may combine these with other pain-relieving drugs.

Narcotic drugs. Drugs such as codeine can also help relieve your pain. People may develop a tolerance if they use narcotics on a regular basis. Consequently, they need to take larger doses. “We're not opposed to narcotics, but we try to use them sparingly and cautiously," Brasington says.

Topical drugs. Some drugs that you put on your skin — such as a lidocaine transdermal patch, which contains an anesthetic — can reduce your pain when you apply them directly to a joint, Brasington points out.

Sleep medications and antidepressants. Dr. Moreland often asks patients who are having pain if they're sleeping well. Too little sleep at night can make you even more sensitive to pain during the day. If this is a problem for you, a sleep aid may be useful. Likewise, antidepressant medications may also be effective in treating sleep problems and reducing pain, Moreland says.

Surgery. In some cases, your doctor may recommend that a surgeon replace a painful joint — such as a hip or knee — with an artificial one, Moreland says. Or a surgeon can fuse the bones in a joint, such as an ankle, to treat the pain.

Transcutaneous Electrical Nerve Stimulation (TENS). In TENS therapy, electrodes are placed on the skin adjacent to painful joints. Electrical impulses are then transmitted through the skin to help block painful input to the nerves in that area. People report varying degrees of pain relief with TENS. Ask your doctor if it might be an option for you.

Physical therapy. A physical or occupational therapist can teach you how to use your hands and other body parts in more effective, less painful ways. Many tools and devices are available to help you do tasks more easily, Brasington notes.

Counseling. Working with a mental health provider is another strategy to help alleviate your pain. A professional can help you learn to relax and change the way you think about your pain and underlying disease. Just talking about your pain can provide a much-needed release.

Many different pain management options are available for people with rheumatoid arthritis — don't hesitate to discuss them with your doctor so you can find the best approach for you.

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